Surgical needle



March 8, 1966 Filed Oct. 19, 1964 H. A. LINCOFF 3,238,942

SURGICAL NEEDLE 2 Sheets-Sheet z INVENTOR. /V 4/Pr:r /4- Z/A/COFF BY 4%M WM United States Patent 3,238,942 SURGICAL NEEDLE Harvey A. Lincotf,Manhattan, Nill. (510 E. 23rd St, New York, NY.) Filed Oct. 19, 1964,Ser. No. 464,532 11 Claims. (Cl. 128-439) This invention has to do withimproved surgical needles and, more specifically, is directed to needlesadapted for ophthalmic use.

In suturing during surgical operations, the surgical needle is graspedby a needle holder between the point of the needle and the rear of theneedle to which the suture is attached, and the needle is positioned atan angle of approximately 90 relative to the jaws of the needle holder.The point of the needle is inserted in tissue to be sutured and theneedle is pushed through the tissue. During insertion of the needle intissue, a conventional needle, which has one or more fiat surfaces or isround at the portion grasped by the needle holder, tends to move in anangular manner with respect to the jaws of the needle holder and torotate about its longitudinal axis, particularly if the serrated jaws ofthe needle holder are worn and if the needle is being passed throughtough tissue. Angular and rotational movements of the needle in theneedle holder during suturing detract from the surgeons control of theplacement of the needle and reduce the speed and efficiency of suturing;such movements are obviously deleterious since they increase theoperating time and since they can be hazardous during delicate surgerysuch as ophthalmic and cardiovascular surgery.

In the repair of retinal detachment, one serious problem associated withthe full thickness, scleral buckling procedure-generally referred to asthe Custodis Procedure For Retinal Detachmenthas been the absence of asuitable surgical needle. To date, needles used in this procedure havebeen deficient in one or more characteristics. In this procedure abroad, securely anchored mattress suture is required to hold a siliconeor other implant securely in place. And it is desirable for theintrascleral portions of the suture to be about 6 mms. in length.Surgical needles, hitherto available, are curved too extensively topermit such a long pass, and the cutting edge customarily on the base ofthe needle blade tends to injure choroid. Most of the needles areexcessive in thickness for safe scleral surgery, since the thickness ofthe sclera varies between about 0.3 mm. under the muscle tendon to about1 mm. in the thicker part at the posterior pole. Grieshaber needlesdeveloped for this procedure have such delicate tips that the tips areprone to be damaged and developed burrs with repeated use.

It has now been found that superior surgical needles, particularly welladapted for the Custodis procedure, comprise A point,

A portion formed by four cutting edges extending from the point toward asuture attaching means positioned at one end of said needle, two of saidcutting edges being positioned along the horizontal mid-line of saidneedle and extending up to about of the total length of the needle, andan upper and lower cutting edge comprising two of said four cuttingedges and being positioned along the vertical mid-line of said needleand being shorter in length than said horizontal cutting edges, andhaving a substantially rhomboidal cross-section formed by said fourcutting edges,

A next portion beyond said rhornboidal cross-section having across-section approximating a hexagon, all sides of which aresubstantially straight, the upper side of said hexagon forming theconcave surface of said needle, the upper and lower parallel sides ofthe hexagon being of substantially equal length and longer than theremaining substantially equally long four sides, and the remaining foursides forming two opposed edges along the horizontal mid-line of saidneedle.

A plurality of advantages are realized with the new surgical needle ofthis invention. The needles are symmetrical about their points,substantially flat on their top and bottom portions, of greater widththan thickness and flatter or less curved than conventional needles,such that the needles tend to find a scleral lamellar plane and dissecttheir way through the sclera with a feeling somewhat like thatexperienced with a blunt dissection, rather than perforating the sclera.Half-thickness sclera sutures are achieved with greater safety thanpreviously possible. Flat surfaces top and bottom throughout the majorportion of the needle length insure secure grasp of the needle by aneedle holder, and these fiat surfaces serve to maintain the needle inthe scleral plane.

It is now possible with the new needles to obtain the long mattresssutures required for full-thickness buckling with greater safety thanheretofore possible. There have been no instances of scleral perforationor of prolapse of the implant due to the tearing free of theintra-scleral portion of the mattress suture. The thinness of theneedles has greatly facilitated sutures in the thinner anterior portionsof the sclera.

Examples of a needle according to the present invention are shown in theaccompanying drawings in which:

FIGURE 1 is an edge view of the plane of curvature of a quarter-circleneedle, and at a right angle to the axis about which the needle iscurved;

FIGURE 2 is a perspective view of the same needle at a right angle toFIGURE 1, showing the plane of curvature;

FIGURE 3 is a fragmental detail of the left-hand portion of the needleas shown in FIGURE 2;

FIGURE 4 is a section of the needle on the line 4-4 of FIGURE 2;

FIGURE 5 is a section of the needle on the line 55 of FIGURE 2;

FIGURE 6 is a section of the needle on the line 6-6 of FIGURE 2;

FIGURE 7 is another edge view of the plane of curvature of a needlehaving a lesser radius of curvature than that of the needle of FIGURES1-6, taken at a right angle to the axis about which the needle iscurved. FIGURE 8 is a perspective view of the same needle at a rightangle to FIGURE 7, showing the plane of curvature.

Referring now to FIGURES 16 in more detail, needle 10 is curved in anarc of a circle, substantially a quartercircle, having a radius ofcurvature not less than about 4.4 mms., and is characterized by portionsof different cross-sections which facilitate its passage through tissue.Extending from point 11 are sharp cutting edges 12, 13, I4 and 15. Upperand lower cutting edges 12 and 13, respectively, are positioned alongthe vertical mid-line of needle 10. Side cutting edges 14 and 15 arepositioned along the horizontal mid-line of needle 10. Cutting edges 14and 15 are up to about of the total length of needle 10, generally up toabout 1.5 mms. in length for a needle of 7.8 mms. total length. Cuttingedges 12 and 13 are much shorter in length than cutting edges 14 and 15,i.e. up to about 0.15 mm. in length. Thus, the cross-section of needleIt near its point 11 is substantially rhomboidal as illustrated inFIGURE 4.

Since cutting edges 12 and 13 are shorter than side cutting edges 14 and15, the cross-section of the next portion extending from point 10 is ofdifferent configuration, namely substantially that of a hexagon. This isillustrated by FIGURE 5. The top side 16 of the hexagon is parallel tothe axis of curvature of the needle. The bottom side 17 of the hexagonis substantially equal in width to a side 16. Sides 18, 19, 20 and 21are the remaining sides of the hexagon and are of substantially equallength. Sides 18 and 19 meet to form cutting edge 14, and sides 20 and21 meet to form cutting edge 15. The depth of needle 10 is the distancebetween sides 16 and 17, and is less than /2 the thickness of thesclera, from about 0.15 mm. to about 0.5 mm.; preferably, it is lessthan about 0.3 mm. All sides of the hexagon 16 through 21, inclusive,are substantially fiat. Thus, handling of the needle by a surgeon isfacilitated by the opposed flat sides, particularly 16 and 17.

The remaining length of needle 10 is substantially rectangular incross-section with all sides being substantially flat as shown in FIGURE6. The absence of cutting surfaces along the length of the needle beyondthe cutting edge portion, protects against the slicing type ofperforation inherently in previous needles.

At the other end of the needle 10, away from point 10, there is locatedsuture attaching means 22 in the form of a channel. Channel 22 receivesand securely holds one end of a suture to be used by a surgeon. Suitablesutures are 5/0 chromic and mersilene.

The needle is continuously tapered as shown by the greater width fromside cutting edges 14 and 15 to the section of the needle approachingchannel 22 as indicated by numeral 23.

Needle 10 illustrated by FIGURES l-6 is particularly advantageous forthe Custodis procedure referred to above.

A preferred needle 10 has the following dimensions, in millimeters:

Length 7.8 Distance across are 7.2 Body width 0.389 Blade width 0.559

Thickness 0.228

Reference is now made to FIGURES 7 and 8, which show a needle ofparticular value for eye muscle surgery. Needle 30 is similar in allrespects to needle 10 except for a smaller radius of curvature. Thus,needle 30 has a radius of curvature of about 2.4 mms., and a chord ofabout 5.1 mms. as measured from point 31 to channel 32. Needle 30 issuitable for scleral sutures that are required deep in the orbit. Thesmaller radius makes it easier for the surgeon to work with when thespace between the globe and the orbital wall is limited.

A suture may be attached to the needle by swaging into a channel or in ahole drilled into the end of the needle.

In attaching sutures to the needles of this invention, any

conventional method can be used, including swaging the suture into achannel or into a hole drilled into the end of the needle.

The needles are thinner than conventional needles. They are formed fromWires less in width than the sclera. Thus, an advantageous thickness forthe needle is less than about 0.3 mm.; needles of 0.228 mm. have provento be suitable.

A suitable technique for forming needles of this invention is asfollows. A raw wire is fed through a straighening device and is cut to ablank length; and a short length at the tail end of the blank is bent 90to allow holding in a needle-making machine. A basic point shape isswaged on the blank. The point is shaped further by grinding so that thepoint fills a bayonetting die which follows at a later operation. Achannel (by which the suture is eventually attached to the finishedneedle) is formed in the blank. The end of the suture channel nearestthe point of the needle is constricted to guarantee an acceptable needleshape after the suture is attached to the needle. The ground point shapeand the main portion of the needle body are now formed into a bayonetshape in a bayonetting die. The bayonetted blank is now flattenedthroughout. The needle blank is discharged from the needle-makingmachine. The needle blank is cleaned and Car heat treated. The needleblank is then electropolishcd in bulk. Only that portion of the blankwhich is to be the finished needle is electropolished.

The needle blank is then loaded onto a finishing machine where thefollowing operations are performed automatically. The edges of theneedle are ground to remove the metal flash (the flash is the thinprotrusion of metal which is squeezed out between the faces of theforming die produced when the bayonet shape is formed). The needlecutting edges are then honed to a very high degree of sharpness. Theforward extremity of the needle (the point and the length immediatelyfollowing the point) is curved. This is the first step in the curving ofthe needle to its final shape. The body of the needle is then curvedfurther, leaving a straight tangent section in the channel area to allowthe future attaching of the suture to the needle by swaging the walls ofthe channel around the suture. The needle blank is then cut, separatingthe finished needle from the tail. The tail is scrap material. Thesuture is attached to the needle by swaging the sides of the channelaround the suture. The needle with suture attached is then curved to thefinal curvature required by the surgeon.

While the structure of the needles of this invention has been describedin terms of the preferred embodiments, minor modifications of thisstructure may result from manufacturing variations and suchmodifications are within the scope of the appended claims.

I claim:

1. A curved scleral surgical needle having an inner concave surface andan outer convex surface and adapted for ophthalmic use consistingessentially of a point,

a suture attaching means positioned at the end of said needle distantfrom said point,

a portion formed by four cutting edges extending from the point towardsaid suture attaching means, two of said cutting edges being positionedalong the horizontal mid-line of said needle and extending substantiallybeyond an upper and a lower cutting edge positioned along the verticalmid-line of said needle, and having a substantially rhomboidalcross-section formed by said four cutting edges, next portion beyondsaid rhomboidal cross-section having a cross-section approximating ahexagon, all sides of which are substantially straight, the upper sideof said hexagon forming the inner concave surface of said needle, theupper and lower parallel sides of the hexagon being of substantiallyequal length and longer than each of the remaining substantially equallylong four sides, and the remaining four sides forming two opposed edgesalong the horizontal mid-line of said needle,

a next portion beyond said hexagonal cross-section having across-section approximating a rectangle, all sides of which aresubstantially straight,

said needle being of greater width than depth and substantially fiatthroughout its length from said rhomboidal cross-section to said sutureattaching means, and

said needle tapering inwardly from the widest portion thereof formed bysaid hexagonal cross-section horizontal mid-lines up to said sutureattaching means.

2. A needle defined by claim 1 wherein the depth thereof issubstantially uniform from said hexagonal cross-section up to saidsuture attaching means.

3. A needle defined by claim 1 wherein said horizontal cutting edges areabout 1.5 mms. in length, measured from said point, and the needle isabout 7.8 mms. in length.

4. A needle defined by claim 1 having a depth from about 0.15 mm. toabout 0.5 mm. between said hexagonal cross-section and said sutureattaching means.

5. A needle defined by claim 1 having a depth of about 0.2 mm. betweensaid. hexagonal cross-section and said suture attaching means.

6. A needle defined by claim 1 wherein said horizontal cutting edgesextend up to about /5 of the total length of the needle.

7. A needle defined by claim 1 continuously tapering inwardly from saidwidest portion thereof up to said suture attaching means.

8. A needle defined by claim 1 having a radius of curvature not lessthan about 4.4 mms.

9. A needle defined by claim 1 having a radius of curvature of about 2.4mms.

10. A needle defined by claim 1 wherein said rectangular cross-sectionhas no cutting edges.

11. A needle defined by claim 1 having the two cutting edges on saidvertical mid-lines up to about 0.15 mm. in length,

the two cutting edges on said horizontal mid-lines up to about 1.5 mms.in length,

a width of about 0.6 mm. at said widest portion thereof,

References Cited by the Examiner UNITED STATES PATENTS Turner 128-339Slater.

Riall 128339 Orcutt 128-339 Kurtz 128--339 X RICHARD A. GAUDET, PrimaryExaminer.

DALTON L. TRULUCK, Examiner.

1. A CURVED SCLERAL SURGICAL NEEDLE HAVING AN INNER CONCAVE SURFACE ANDAN OUTER CONVEX SURFACE AND ADAPTED FOR OPHTHALMIC USE CONSISTINGESSENTIALLY OF A POINT, A SUTURE ATTACHING MEANS POSITIONED AT THE ENDOF SAID NEEDLE DISTANT FROM SAID POINT, A PORTION FORMED BY FOUR CUTTINGEDGES EXTENDING FROM THE POINT TOWARD SAID SUTURE ATTACHINE MEANS, TWOOF SAID CUTTING EDGES BEING POSITIONED ALONG THE HORIZONTAL MID-LINE OFSAID NEEDLE AND A LOWER CUTTING SUBSTANTIALLY BEYOND AN UPPER AND ALOWER CUTTING EDGE POSITIONED ALONG THE VERTICAL MID-LINE OF SAIDNEEDLE, AND HAVING A SUBSTANTIALLY RHOMBOIDAL CROSS-SECTION FORMED BYSAID FOUR CUTTING EDGED, A NEXT PORTION BEYOND SAID RHOMBOIDALCROSS-SECTION HAVING A CROSS-SECTION APPROXIMATELY A HEXAGON, ALL SIDESOF WHICH ARE SUBSTANTIALLY STRAIGHT, THE UPPER SIDE OF SAID HEXAGONFORMING THE INNER CONCAVE SURFACE OF SAID NEEDLE, THE UPPER AND LOWERPARALLEL SIDES OF THE HEXAGON BEING OF SUBSTANTIALLY EQUAL LENGTH ANDLONGER THAN EACH OF THE REMAINING SUBSTANTIALLY EQUALLY LONG FOUR SIDES,AND THE REMAINING FOUR SIDES FORMING TWO OPPOSED EDGES ALONG THEHORIZONTAL MID-LINE OF SAID NEEDLE, A NEXT PORTION BEYOND SAID HEXAGONALCROSS-SECTION HAVING A CROSS-SECTION APPROXIMATELY A RECTANGLE, ALLSIDES OF WHICH ARE SUBSTANTIALLY STRAIGHT, SAID NEEDLE BEING OF GREATERWIDTH THAN DEPTH AND SUBSTANTIALLY FLAT THROUGHOUT ITS LENGTH FROM SAIDRHOMBOIDAL CROSS-SECTION TO SAID SUTURE ATTACHING MEANS, AND SAID NEEDLETAPERING INWARDLY FROM THE WIDEST PORTION THEREOF FORMED BY SAIDHEXAGONAL CROSS-SECTION HORIZONTAL MID-LINES UP TO SAID SUTURE ATTACHINGMEANS.